Analysis Of Viral Encephalitis And Meningitis In Patients With Immunoglobulin Index And Synthesis Rate

Objective To explore the immune response of CNS in the viral encephalitis and meningitis by examining the intrathecal synthesis of IgA,IgM and IgG in patients with these diseases.Methods We collected the cerebrospinal fluid and the serum samples simultaneously from thirteen patients with viral encephalitis,fifteen patients with meningitis(five cases with tuberculous meningitis,nine viral meningitis and one purulent meningitis) and fifteen non-CNS-inflammation control subjects.The concentrations of immunoglobulin (IgA,IgM and IgG) and the albumin in the serum and the cerebrospinal fluid were determined with immuno-scattering turbidimetric method,IgA index,IgM index,IgG index and 24 hour intrathecal IgG synthesis rate were calculated.Results1.The cell count,concentrations of CSF protein,IgA,IgM,IgG and the albumin quotient,the IgA index,IgM index,IgG index and the 24 hours IgG synthesis rate are significantly higher in the meningitis patients than those in the control group(P <0.05 ).2.The cell count in the viral encephalitis patients is slightly higher than that in the control group(P <0.05);the concentrations of CSF protein,IgA,IgM,IgG and the albumin quotient,the IgA index,IgM index,IgG index and 24 hours IgG synthesis rate in the viral encephalitis patients is slightly higher than that those in the control group,but the differences were not significant(P>0.05);.3.The cell count,concentrations of CSF protein,IgA,IgG and the albumin quotient, the IgA index,IgG index and 24 hours IgG synthesis rate in the meningitis patients is slightly higher than that those in the viral encephalitis patients(P<0.05).The IgM and the IgM index in the meningitis patients is slightly higher than that in the viral encephalitis patients,but the differences were not significant(P>0.05).4.The IgG and the IgA index in the viral meningitis patients is slightly higher than that in the viral encephalitis patients(P<0.05);the cell count,concentrations of CSF protein,IgA,IgM and the albumin quotient,the IgM index,IgG index and 24 hours IgG synthesis rate in the viral meningitis patients is slightly higher than that those in the viral encephalitis patients,but the differences were not significant(P>0.05).5.The concentrations of CSF protein,IgA,IgM,IgG and the albumin quotient,the IgM index and 24 hours IgG synthesis rate in the tuberculous meningitis patients is higher than in the viral meningitis patients(P <0.05 );The cell count,the IgA index and IgG index in the tuberculous meningitis patients is higher than in the viral meningitis patients,but the differences were not significant(P>0.05).Conclusion1.Compared with patients without intracranial infections,there are breakdown of blood-nerve barrier and humoral immune responses in CNS in the patients with viral meningitis and viral encephalitis.The intensity of CNS humoral immune response in viral meningitis is higher than that in viral encephalitis,which may be related to the intracellular involvement of viral encephalitis.To get rid of virus from nerve tissues, cellular immune response is required,while humoral immune response is relatively milder.But in viral meningitis,much virus is spreading in the subarachnoid space extracellularly,which may induce stronger humoral immune response than viral encephalitis.2.The intensity of CNS humoral immune response in meningitis caused by non-virus infectious agents is higher than that in viral meningitis,which may be related to extracellular involvement of these infection factor.To get rid of virus from nerve tissues,cellular immune response is required.